Aim-To evaluate the ability of structural parameters (as determined by retinal nerve fibre layer (RNFL) measurements obtained with the scanning laser polarimeter (SLP-NFA/GDx)) and functional parameters (as determined by automated perimetry) to discriminate between normal and glaucomatous eyes. Methods-In a case-control study, a total of 91 normal subjects and 94 patients with glaucoma underwent automated perimetry and RNFL measurements obtained with the SLP. Three independent scans of each eye were obtained and a mean image was created and used for further analysis. There has been increasing evidence that retinal nerve fibre layer (RNFL) analysis may improve the diagnosis of early glaucomatous damage.
Aims-To verify and evaluate the eVect of reinsertion of the lower eyelid retractor aponeurosis to correct involutional entropion. Methods-The involutional entropion is one aVection that occurs mainly in the lower eyelid of patients over 60 years old. The surgical techniques proposed to correct this condition are based on correction of horizontal laxity-the preseptal orbicularis muscle overrides the pretarsal muscle, and the reinsertion of the lower eyelid retractor aponeurosis. 30 patients clinically diagnosed with involutional entropion and randomly selected underwent reinsertion of the lower eyelid retractor aponeurosis to the tarsal plate, without horizontal shortening or resection of the skin or orbicularis muscle. Results-Good anatomical and functional correction was achieved in 96.6% of the patients and no recurrence was observed on 29 month follow up examination. The surgical result was very satisfactory. Conclusions-It was concluded that this procedure is eVective and has low recurrence rate, showing the important role of the reinsertion of the lower eyelid retractor aponeurosis in this surgical correction. (Br J Ophthalmol 2000;84:606-608)
ABSTRACT.Purpose: To evaluate the influence of age, sex, race, refractive error and optic disc topography on the sensitivity and specificity of scanning laser polarimetry (SLP) in the diagnosis of glaucoma. Methods: A total of 88 normal individuals and 95 glaucoma patients were included in this study. Glaucoma was defined on the basis of both optic nerve damage and visual field defects. Scanning laser polarimetry, optic disc topography, automated perimetry and refractometry were performed in all subjects. The sensitivity and specificity of SLP were assessed applying a previously calculated cut-off to a previously described linear discriminant function (LDF). Results: The sensitivity and specificity of SLP in the study population were 82% and 83%, respectively. Sensitivity and specificity were not affected by age, sex, race, average disc diameter or disc area. The sensitivity of SLP tended to be higher in myopes (93%) than in emmetropes (80%) and hyperopes (71%) (p ¼ 0.08). Sensitivities were higher in individuals with cup areas > 0.96 mm 2 (89%), rim areas 1.36 mm 2 (92%), and cup area/disc area ratios > 0.45 (89%) (p < 0.05). Stepwise logistic regression analysis indicated that the presence of a cup area > 0.96 mm 2 and a rim area < 1.36 mm 2 significantly increased the sensitivity of the LDF, whereas a cup area/disc area ratio 0.45 significantly increased the specificity of the LDF. Conclusion: The sensitivity and specificity of SLP may be influenced by refractive error and optic disc parameters that are affected by glaucomatous damage (cup area, rim area and cup area/disc area ratio). These parameters must be considered in studies evaluating the sensitivity and specificity of optic nerve/ retinal nerve fibre layer imaging technologies.
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